Exactly how and why is this policy so problematic? The answer lies in several widespread assumptions that are rooted in our culture and have a long history of causing much harm to many transgender people as well as intersex people in our society. Pin pointing these dangerous, incorrect assumptions is in fact pin pointing the very basis for the violence and harm our society's gender minorities face.

Paul Southwick, the lawyer representing Jayce, made a statement expressing his disappointment in the new policy that outlines well some of these underlying problems with George Fox's housing policy. Southwick told University Herald:

If George Fox University is drawing the line at gender reassignment surgery, that is not the line drawn by state and federal law. Gender identity protections do not extend only to those individuals who can afford, or who are ready, for gender reassignment surgery…And how would George Fox police anatomy?

Anatomy policing can involve a dangerous set of assumptions, including that anatomy is always clear-cut as being "male" or "female," or the assumption that anatomy is what defines gender at all. Consider intersex people, for example, who may have genitalia and/or sex chromosomes that are ambiguous to conventional standards. Where does one draw the line in deciding which of these perceived ambiguous physical characteristics should be considered "male" or "female"?

To start with, lying to patients is not only unethical, it is bad medicine. Patients who were lied to figured that much out, and often stopped getting medical care they needed to stay healthy. (For example, some stopped taking hormone replacement therapy—critical after gonadectomy—and wound up with life-threatening osteoporosis at an early age.) They also suffered psychological harm from these practices, because they got the message that they were so freakish even their doctors could not speak the truth of their bodies to them. (A lot of doctors still have not told their present and former patients the name of their conditions. Some still withhold medical records from patients and from parents/guardians of minor children.)

Second, the system was and is literally sexist: that is, it treats children thought to be girls differently than children thought to be boys. In this approach … doctors’ primary concern for children thought to be girls is preservation of fertility (not sexual sensation), and for children thought to be boys, size and function of the phallus.

Third, the “standards” used for genital anatomy have been arbitrary and illogical. For example, under the “optimum gender of rearing” model, boys born with penises doctors considered small were made into girls—even though other doctors believed (and showed3) they could be raised as boys without castration, genital surgery, and hormone replacement. Girls with clitorises their doctors think are “too big” still find themselves in operating theatres with surgeons cutting away at their healthy genital tissue.4

…

There is substantial evidence that people who have been treated under the “optimum gender of rearing” model have suffered harm, psychological and physical. This does not mean doctors intended to harm their patients; far from it. But good intentions are inadequate reasons to maintain a practice that has shown to be unethical and unscientific.

Finally, parents consenting to intersex surgeries do not appear to be fully informed about the available evidence, about alternatives available to them, about the risks associated with surgeries, or about the theoretical problems underlying the “optimum gender of rearing” approach. For example, they are typically not told the evidence that gender identity may emerge to an important degree from prenatal hormonal actions on the brain—and thus, that you can’t “make” a child a maintain a particular gender identity in the long term by doing surgery on him or her in infancy.6

…many transgender people choose not undergo surgical changes to their bodies, either because they cannot afford it, because they do not wish to sacrifice their reproductive ability, or because they simply do not feel it is a necessary step to realize their gender identities. The National Transgender Discrimination Survey found that at most, a quarter of trans people had already had some form of genital surgery, though many more wanted to someday. In turn, the World Health Organization recently condemned any policy that requires transgender people to undergo sterilizing surgery in order to obtain legal recognition.

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The most apparent conflict with this new policy, however, is that even if a student is ready and willing to undergo a surgical transition, George Fox’s student health insurance policy does not cover any transition-related care. According to the 2013-2014 plan, the following services are all listed under exclusions for coverage: sexual reassignment surgery, growth hormones, and surgical breast reduction. Thus, the university discriminates against transgender students who have not had surgery and simultaneously creates obstacles for transgender students who would want to.

ThinkProgress' point that not all trans people want bottom surgery is especially important in allowing acknowledgement, legitimization, and justice for the entirety of all members of the diverse trans community, who are often marginalized by our culture's obsession with defining gender by genitalia.

Another argument ThinkProgress makes is in regards to trans people who just aren't ready to make a big decision like bottom surgery. ThinkProgress stated, "the World Professional Association for Transgender Health [WPATH] recommends in its Standards of Care that candidates for surgery be of an age of consent, and that they have undergone at least one full year of hormone therapy. As a predominantly undergraduate university, this means that most of the students impacted by the policy are young and may not be ready to commit to such a life-changing decision."

While this is indeed an important point for people who are not ready for such a huge decision, WPATH's Standards of Care that ThinkProgress references, while certainly improved in comparison to recent years, is in fact highly controversial among trans people and supporters. WPATH's model of trans healthcare has historically included gatekeeping standards that have created unnecessary barriers for trans people in accessing the medical treatment they need. For example, in the past, WPATH recommended that trans people commit to at least a year of psychotherapy before undergoing hormone replace therapy (HRT), widely influencing doctors to require this standard for trans people. This standard renders HRT inaccessible to many trans people who could not afford a year of psychotherapy sessions. It also puts the role of agency in the psychotherapist, as opposed to the trans person, and who could know if a person is trans more than that person themselves? Psychotherapists influenced by this model often discrimination against non-binary people – people who do not identify as fully female or fully male – and block such people from accessing the treatment they need on the grounds that they are not "trans enough." Even the standard ThinkProgress references includes a problematic assumption that all trans people are the same; saying that trans people should undergo a year of HRT before undergoing surgery assumes all trans people who want surgery also want to undergo HRT, when in reality all trans people have different interests and needs.

A much more accepted model among trans people and supporters is the Informed Consent Model, which simplifies access to the medical treatment trans people need. Check out this Informed Consent resource for a more thorough description of the model and the problems with the older gatekeeping model that still has a large influence on today's healthcare providers.

According to Advocates for Informed Choice, a nonprofit organization advocating on behalf of intersex children, an estimated one in 2,000 babies is born with a reproductive or sexual anatomy and/or chromosome pattern that doesn’t seem to fit typical definitions of male or female.

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